Assessment of timing of hydrocortisone treatment and vasoactive inotrope scores in pediatric septic shock cases
ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, cilt.15, sa.5, ss.355-359, 2024 (ESCI)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 5
- Basım Tarihi: 2024
- Doi Numarası: 10.4328/acam.22126
- Dergi Adı: ANNALS OF CLINICAL AND ANALYTICAL MEDICINE
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI)
- Sayfa Sayıları: ss.355-359
- Ondokuz Mayıs Üniversitesi Adresli: Hayır
Özet
Aim: We aimed to investigate the relationship between the demographic characteristics of patients with septic shock who received hydrocortisone treatment, and the time of treatment initiation, doses, the relationship with different inotropes, and the relationship with vasoactive inotrope score. Material and Methods: Our study included critically ill pediatric patients (n=41) while being monitored in the Pediatric Intensive Care Unit. Demographic data, primary diagnoses, systolic/diastolic/mean blood pressure levels, echocardiographic imaging findings (if any), hydrocortisone dosage, time of initiation after the first inotrope, total time of use, vasoactive inotrope scores and mortality status of patients were recorded in the data system and analyzed. Results: Median (IQR) hydrocortisone infusion time was 36 (43) hours, time of initiation after the first inotrope median (IQR) was 24 (38) hours according to the calculation performed. There was no difference in initiation timing and infusion duration of hydrocortisone treatment between patients who received dopamine, dobutamine, or milrinone and those who did not (p>0.05). There was no correlation between the time after inotrope initiation and the infusion time of hydrocortisone (p=0.217, r2=-0.197). No significant difference was observed between mortality rates within the first 24 hours and at day 7, and the vasoactive inotrope score (p=0.345, p=0.954) Discussion: Our study evaluated various parameters in patients who received hydrocortisone. If adrenal insufficiency is not previously diagnosed, it may take some time to consider the possibility of catecholamine resistance and decide to initiate hydrocortisone treatment. The definition of catecholamine-resistant septic shock is not clearly defined by a specific time.